AB1346 ASSOCIATION OF URIC ACID LEVELS WITH COVID-19 SEVERITY DURING 2020 AND 2021 YEARS
Authors: A. Sydorova, O. Iaremenko
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The decrease in uric acid levels attracts more and more attention from clinicians every year [1]. In particular, a factor such as Covid-19 can cause a significant decrease in uric acid due to its increased excretion by the kidneys [2]. This retrospective study aimed to determine changes in the level of uric acid in different years, which allows us to assume the influence of different strains of Covid-19 on uric acid. <h3>Objectives</h3> To analyze the relationship between uric acid levels through admission to the hospital and Covid-19 severity during 2020 and 2021 years. <h3>Methods</h3> Our retrospective study includes 127 hospitalized patients with confirmed Covid-19 in 2021 and 63 patients in 2020 (only patients who didn't receive urate-lowering therapy). Most patients were over 45 years old (84,2% vs 90,5%), women and men almost equally. The severity of Covid-19 we determined by the type and presence of oxygen support ((1) without O2, (2) O2 by mask or nasal cannula, (3) continuous positive airway pressure, (4) positive bi-pressure in the airways or high-flow oxygen, (5) invasive ventilation). A chi-squared test and comparison of means were used. <h3>Results</h3> We cannot establish the dependence of the uric acid level on the severity of the course of the Covid-19 disease, which is determined by the type of oxygen support in both 2020 and 2021. For example, in 2021, the difference between the least severe type (without O2) and the most severe (invasive ventilation) was almost the same (246.2 vs 277.12 µmol/L), as between O2 by mask or nasal cannula and positive bi-pressure in the airways or high-flow oxygen (257 vs 239.1 µmol/L). However, it was established that in 2020, higher indicators of the level of uric acid were observed for all types of oxygen support. For example, for patients who were without O2, it is higher by 72.95 µmol/L, which is statistically significant. In addition, we analyzed the dependence of the uric acid level on such indicators as the patient's age, the level of lymphocytes, C-reactive protein, and LDH at admission to the hospital. As a result of the analysis, it was found that the dependence is present for the LDH indicator (the lower the LDH, the higher the uric acid: chi-square at the level of 0.05), and for all other indicators, it was absent in 2021. In 2020, a positive relationship between CRP, LDH, and uric acid levels was also observed. <h3>Conclusion</h3> Although there is a trend towards lower uric acid levels in the background of Covid-19, it is not a marker of a severe disease course. The lower uric acid levels in 2021 are likely due to a feature of the strains circulating in 2021 that caused more significant renal excretion of uric acid. <h3>References</h3> [1]Hu F, Guo Y, Lin J, Zeng Y, Wang J, Li M, Cong L. Association of serum uric acid levels with COVID-19 severity. BMC Endocr Disord. 2021 May 8;21(1):97. DOI: 10.1186/s12902-021-00745-2. PMID: 33964922; PMCID: PMC8106517. [2]Dufour I, Werion A, Belkhir L, Wisniewska A, Perrot M, De Greef J, Schmit G, Yombi JC, Wittebole X, Laterre PF, Jadoul M, Gérard L, Morelle J; CUSL COVID-19 Research Group. Serum uric acid, disease severity, and outcomes in COVID-19. Crit Care. 2021 Jun 14;25(1):212. DOI: 10.1186/s13054-021-03616-3. PMID: 34127048; PMCID: PMC8201458. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.